Pakistan – TED Bloghttp://blog.ted.com
The TED Blog shares interesting news about TED, TED Talks video, the TED Prize and more.Fri, 09 Dec 2016 15:33:28 +0000enhourly1http://wordpress.com/http://1.gravatar.com/blavatar/909a50edb567d0e7b04dd0bcb5f58306?s=96&d=http%3A%2F%2Fs2.wp.com%2Fi%2Fbuttonw-com.pngPakistan – TED Bloghttp://blog.ted.com
Filmmaker, blogger … butcher? How TED Fellow Bassam Tariq works to upend conventional views of Muslim lifehttp://blog.ted.com/ted-fellow-bassam-tariq-upends-conventional-views-of-muslim-life/
http://blog.ted.com/ted-fellow-bassam-tariq-upends-conventional-views-of-muslim-life/#commentsFri, 30 Jan 2015 17:43:03 +0000http://blog.ted.com/?p=95171[…]]]>Artist Bassam Tariq is determined to shine a light on the incredible diversity of Muslim life – and he does it by any means necessary. Known for his blogging project 30 Mosques in 30 Days, Tariq and a friend took a month-long road trip through all 50 states, breaking their Ramadan fast each evening in mosques along the way and documenting the people they met.

He also traveled to Pakistan to film These Birds Walk, a documentary celebrating the life of the unassuming man who created Pakistan’s first ambulance service, through the lens of a coming-of-age story. And if that’s not enough, back home in New York City, Tariq cofounded Honest Chops, a halal butcher shop in the East Village that offers high-quality meat to his neighbors, 90 percent of whom aren’t even Muslim.

As his TED Talk, “The beauty and diversity of Muslim life,”is released, we spoke to Tariq about the unifying vision behind these wildly disparate projects, and how they each serve to alter perspective on what it means to be Muslim.

Your arsenal of talents is somewhat bewildering — butcher, blogger, filmmaker. How did you get here?

I was born in Pakistan, but after a short time in New York, where we lived in a very middle-class Astoria neighborhood, we moved to Houston — to the hood — when I was about 11. We didn’t even realize how bad the neighborhood was at first, because New York was so dirty in the ’90s. It was a subsidized housing complex. We thought, “Wow, this is so nice and so big!” It turned out to be violent.

I realized that everything was divided by race. It felt really weird, because in New York, we all just got along and everyone was from a different background. This neighborhood was a predominantly African-American area, and we were the only brown kids, and we always got into fights — always. So I started lying to people, and told them I was Jewish, just to get around. I didn’t want to be called “Gandhi.” To me, that was the worst thing you could be called.

I can think of worse people to be.

I know, right? But my attitude was, “That stupid little Indian man ruined everything for me.” They’d show videos of him in school, and everyone would be like, “Yo, that’s your dad.” And I was like, “Oh my god. No, I’m Pakistani.” People would respond: “What’s that?” No one really even knew where it was on a map.

Then, when we moved into the suburbs, we lived among more affluent people. It was the first time I started seeing a lot of white people in my life. I was in ninth grade. And I thought, “This is weird. These are American, WASPy white people.” Very different from the Greek and Italian kids that I grew up with [in New York]. That’s when I started seeing a different side of privilege. Until then, I believed our problems were due to having a victim mentality. When I went to college, I got involved with student organizations. The pivotal point for me was 9/11. I was forced to deal with Islam and what it meant to me — if anything. It’s such a cliché. But our politics and beliefs were put in the spotlight.

I also met affluent Pakistani kids who grew up wealthy, and until then I had no idea what that wealth was like. My dad worked in a restaurant, and we owned a gas station — that was our upward mobility — and we weren’t particularly religious. My dad would open the doors to the mosque in the morning, and then he’d go to open up the gas station. Later, we closed the gas station and my dad then opened a Chinese restaurant.

How’d that go?

It was really good food — Pakistani-Chinese fusion. It was awful as a business; it only lasted about a year-and-a-half. But my dad’s a great cook.

Above, watch the trailer for These Birds Walk, Bassam Tariq’s documentary feature that follows the coming-of-age story of two boys in Pakistan.

What did you grow up thinking you’d do?

I thought I’d go into business, or maybe become a doctor. I was the first one in my family to get to go to college, so it was a big deal. But during that time, because my parents couldn’t afford college, I was signed up as a subject for medical tests to make money. It was dehumanizing. They’d hook me up to these weird machines and feed me medicine, and then follow my heart rate and so on. Then I took this class called “Creativity in American Culture,” and that really shifted my perspective on what was possible. I picked up a camera and thought, “I’ll start shooting videos. That might make some money.” I learned how to edit from a friend, and then did corporate videos — like videos for the university mental health department, and so on.

Is that why you became a filmmaker?

Yes, but I didn’t have an interest then in the art of film. In the beginning, I was excited about the creativity of advertising, and that’s the route I took after I graduated and moved to New York. It was really tough, being the only non-white person in the creative world of advertising. It’s very, very homogenous, and there’s no nuance to stories. There’s a façade of creativity, a sense that you’re changing the world. But I saw through it, and I ultimately got axed from my first job due to my lack of interest.

How did end up making These Birds Walk?

When I went to New York, I wanted to get away from Muslims, because in Texas, I saw how we bubbled ourselves. But as soon as I got to New York, I ended up meeting Muslims — and they were an amazing group of creative artists. My roommate, for example, was a filmmaker named Musa Syeed. He was setting his own rules, doing things his own way, and he was unapologetic about his beliefs and his practices. Until I met Musa and others in this circle, I’d worried more about being the token Muslim, that my work would be only for Muslims. Even now, for These Birds Walk, it was really important for me to make it about universal themes — family, youth, growing up.

Salaam Ali, a bus driver and poet, prepares for his afternoon bus route in Karachi. Image: These Birds Walk

During this time, I read about a humanitarian in Pakistan named Abdul Sattar Edhi, who started the first ambulance system in all of Pakistan, in the early 1950s. He owned a candy store and had only a fourth-grade education. He sold the store, bought a van, and on the side of the van wrote “poor man’s van.” Then he began transporting the sick and the dead all over Pakistan.

Little did he know it was the first ambulance in the entire country. Today, he runs the largest private ambulance service in the world. He’s old now, and only has two shirts to his name. He takes a shower once a month, has the worst teeth that you’ve ever seen — you would mistake him for a beggar on the street. He is not Mother Teresa — his work is secular — but he’s a religious man himself. But he’s radically independent, doesn’t take money from any governments, doesn’t take money from missionaries. Everything comes from private, local donations.

How did you approach him?

We just went in there, and said, “We want to make a film on you.” He said, “No. Because if you want to know me, you must see me through my work.” He threw us that challenge, and that’s the film. It provides a lens to understand who this man is, and the work of an unapologetic humanitarian.

Tell us about the children in the film.

The story is told from the point of view of an 8-year-old boy named Omar — he’s a real kid. We find him in this little home for runaways that Edhi runs, and he and his friend Shehr are sitting there, talking about their parents. Shehr deeply regrets running away from home. He starts the conversation: “Will our parents bless us if we’ve broken their hearts?” The light bulb went off. These kids made the decision to leave their families.

See, the tragedy of orphans is a little more clear-cut. They have no one, and that’s why they’re where they are. But these runaway kids made a choice. And that element of choice raises the stakes and questions. Can these kids redeem themselves? What does it mean to them to find family, and what does home mean? Abdul Sattar Edhi is part of the context of the story, but then he’s out. We come back to him towards the end of the film, but the hope is that his presence is felt throughout.

Runaway kids from Banaras Colony in Karachi sitting in the corridor of the Edhi Home. They were brought here after surviving a bomb blast in their neighborhood. Image: These Birds Walk

Do you think of yourself as an artist? And is your meat shop art?

I consider myself a worker and some of the work that I do fits into a larger conversation. How I enter that conversation and who I’m speaking to can sometimes be considered art. In terms of the meat shop, it’s funny that you ask that. Having an organic halal butcher in the East Village’s Fashion District does feel like a weird piece of performance art.

What are the communities you serve at the butcher shop?

There are three. Our bread-and-butter clients are the local East Village community, who are the kids of artists, hipsters, people who work in start-ups. They come to us every day, and really love us. Then we have a young professional Muslim community. They’re the ones that order online, and we deliver to their houses. They’re a lifeline for us, because they were the ones that we started it with and for.

We also have a large local immigrant community — the Bengali families, the Chinese families, and so on. These are the people who are overlooked and underserved, and we try to reach out to them. Unfortunately, we are not doing as great a job as we wished. They’ve been in the neighborhood longer than the skinny-jean-wearing hipster — people like us. They’re the ones that want to get out of the neighborhood, but are stuck for whatever reason. I’ll admit: our larger base is the hipsters — the people that go to Mud Coffee, who patronize artisan boutiques. And we knew that they would be the first ones to understand what we were up to.

Breaking into the greater Muslim community is tougher because we have long-held traditions around what a meat store should look like. So your traditional Muslim family might think we’re overpriced from how we look from the outside. But we’re not. You probably spend two dollars more, but you’re getting organic meats from some of the best local farmers.

To what degree are you a butcher? Do you know how to slaughter?

At the store, we all know how to do basic butchering. And yes, I’ve slaughtered a couple of animals in my life. I slaughtered two lambs recently, but I don’t think I could do a steer. It’s too much. It’s a very emotional experience to kill an animal, as it should be. It’s not something you should take lightly. This animal has died for you. I think everyone should do it at least once in their life, if they eat meat. We’re so removed from the process of food production. Part of me thinks it’s okay to be removed from vegetables, because there’s always ground to grow them, but when it comes to meat, and the way we consume meat in the West as people of privilege, is unbelievable.

Tariq opened Honest Chops halal butcher store in the heart of New York’s East Village in Manhattan. Their mission: “To change the world’s relationship to their food.” Photo: Omar Mullick/Honest Chops

How did you begin the 30 Mosques in 30 Days project?

During the production of These Birds Walk, which took a long time and a lot of back-and-forth trips to Pakistan, I was making videos for Time magazine on the side, for income. I’m not a journalist — I didn’t want to be pushed do work just because other people considered it topical. We develop ideas of what is urgent based on current events that the media say are of importance. That’s my problem with mainstream journalism — the reason anyone should care about Islam is because it’s linked to terrorism that links back to America. You end up reducing people to sociopolitical ideas.

In any case, on one of these trips back to New York, it was Ramadan. It was 2011. My friend Aman Ali contacted me and said, “Hey, let’s do this 30 Mosques thing around America.” We’d done it before, the first time just around New York, as a small Tumblr blog. But this time, we decided to visit all 50 states for two years in a row.

When you guys went into these different communities, were you welcomed with open arms?

Generally we were. It’s important to note that being Pakistani men in mosques has its advantages. We are usually given better treatment and accommodations than most. But we were kicked out a couple of times — in Mobile, Alabama, for instance. It was sensitive, because somebody was supposedly an Al Qaeda spy in the community. The media had a frenzy and the community couldn’t afford any more attention.

The journey made me realize that a mosque can restore dignity for a lot of immigrants. For them, it can be a point of pride, and that’s why they want to build these structures, which can be quite bombastic. To me, it’s a little gaudy, but to them, it’s like, “No, this is us.”

So it offers people a focal point.

Yeah, I think it does. And I have to respect that. A community isn’t a structure — a community’s also your warmth and how you welcome people. But I have to admit that going into it that year, we had a very critical eye. We were skeptical in a lot of our writings. So we got a lot of backlash on the way we were writing, because I sometimes questioned or challenged what I was observing.

I also learned a lot about being a New York kid coming in and being critical. A lot of small communities have a complex. “You’re a big-city kid trying to tell us what to do,” they’d complain. They had a point. Who am I to come in, spend literally 10 hours in someone’s community, and write off certain things? But I also felt I had to be able to say, “No, but you also need to stop drinking your own Kool-Aid.”

Muslims in the woods of South Carolina sit together and share stories after they break their Ramadan fast. All of them have become acclimated to the stark darkness of the night. Photo: Bassam Tariq, 30 Mosques in 30 Days

The idea really took off. What did you think when people started mimicking the project around the world?

There were about 20 different communities around the world that started doing 30 Mosques. It was cool to see people in Indonesia doing it, people in Saudi Arabia, people in Malaysia. In one project, “Pink Mosques,” these women decided, “You know what? We’re going to start visiting mosques to see how welcomed we are.” There’s another blog that started by Hind Makki called Side Entrance, which refers to women and their entryway into communities. It’s helped start such a powerful discussion in our community about space.

You’ve been using the term “my community” a lot. Do you mean the Muslim community as a whole?

That’s a good question. I don’t know. It’s a fluid identity, I think. I don’t quite know what it means. I wish I knew. It’s a cross-section of people and beliefs of people that are trying to find a space in a weird world where people are telling us to conform into different standards. We have people from the State Department that are telling us to whitewash our thoughts, that it means “Muslim” is to be somebody that does X, Y and Z — and I hate that. I feel like people in the Muslim community entrench that as well, a little bit. We’re afraid of what people think of us, so we want to put the cutest, smiliest dude on a podium: “We’re Muslim, we’re just like you! Love us!” We’re afraid of talking about things that make us different — the convictions, the rigorous orthodoxy of many mainstream folks. That’s something that I’ve been trying to explore more.

Nur, left, holds hands with her husband, David, for the first time. David was in incarcerated in South Dakota, and they had exchanged letters for years. She met him for the first time the day before this photo. Photo: Bassam Tariq, 30 Mosques in 30 Days

I wonder whether the act of acquiescing to an accepted stereotype makes it a little easier to carry on living a private life without having to defend it all the time.

Yes. And for the projects that I’ve worked on, I have to ask myself, “Are we really doing a better job of communicating these stories of our community?” Sometimes yes, sometimes no. 30 Mosques, for example, was a superficial construct. But in that framework, we were trying to build something inventive. The hope is that it doesn’t read as being apologetic or defensive, but as something that is complicated and nuanced. The power of good art is that it forces the audience to reach their own conclusions. Whatever resolution they come up with, that then also is an understanding of themselves.

How does all this sit with your parents and what they wanted for you? How does it fit in with their experience?

My mother’s message was always to work for someone else, get health insurance, and provide for your family. It’s the standard immigrant dream: live a better life than we did. Make more money, and don’t forget to send money home. That responsibility is an important part of growing up.

I do send money home to my family because their economic reality hasn’t changed much since I was a kid. My mom and dad still work. They’re never going to retire, because it’s just difficult when you aren’t working a professional job with corporate benefits. Social Security might give them a little bit, but not enough. My older brother helps around the house, and he’s the one that works and provides. This makes it easier for me to then do all the things I do. If it wasn’t for my bhai (brother), I don’t know where I would be.

So I feel that whatever I do, it’s also for them. Whatever I do has to be worth it.

]]>http://blog.ted.com/ted-fellow-bassam-tariq-upends-conventional-views-of-muslim-life/feed/3Processed with VSCOcam with g3 presetmmechinitaBassam-Tariq-TED-Talk-CTASalaam Ali, a bus driver and poet, prepares for his afternoon bus route in Karachi. Image: These Birds Walk Runaway kids from Banaras Colony in Karachi sitting in the corridor of the Edhi Home. They were brought here after surviving a bomb blast in their neighborhood. Image: These Birds WalkTariq opened Honest Chops Halal butcher store in the heart of New York's East Village in Manhattan. Their mission: "Here to change the world’s relationship to their food." Photo: Omar Mullick/Honest ChopsMuslims living in the woods of South Carolina sit together and share stories after they break their Ramadan fast. All of them have become acclimated to the stark darkness of the night. Image: 30 Mosques in 30 Days Nur, left, holds hands with her husband, David, for the first time. David was in incarcerated in South Dakota, and they had exchanged letters for years. She met him for the first time the day before this photo. Photo: 30 Mosques in 30 DaysA woman prays inside a Muslim women’s shelter in Baltimore, Maryland. Image: 30 Mosques in 30 Days How a TED Fellow’s mobile triage app could save lives around the worldhttp://blog.ted.com/how-a-ted-fellows-mobile-triage-app-could-save-lives-around-the-world/
http://blog.ted.com/how-a-ted-fellows-mobile-triage-app-could-save-lives-around-the-world/#commentsThu, 22 Jan 2015 11:25:12 +0000http://blog.ted.com/?p=95080[…]]]>

Every day, emergency room workers use triage to prioritize patient care — but exhausted personnel in under-resourced hospitals can easily make deadly errors in diagnostic tests and symptom scoring. South African emergency room doctor Mohammed Dalwai witnessed such avoidable tragedy firsthand while working with Médicins sans Frontières in Pakistan. He resolved never to let it happen again.

Dalwai urged MSF to apply a standard triaging system — the paper-based South African Triage Scale — in his emergency room in Pakistan. This led to an 86% improvement in successful triaging, and to MSF adopting this standard in emergency rooms around the world. It also led to a big idea for Dalwai. Now, with The Open Medicine Project (TOMPSA), he and his team have made an app that is freely available. They are planning to roll it out across many regions.

Here, Dalwai tells the TED Blog about the app’s development, and its possible future uses — including the ability to track realtime data of disease outbreak.

How did you end up joining Médicins sans Frontières and creating the Mobile Triage App?

I actually always wanted to be a biomechanical engineer! But then I started studying medicine, and fell in love with it after the third year, when I began seeing patients. That was it for me. I finished med school at Stellenbosch University, and afterwards went into rural medicine. I went into the bush to work at Manguzi Hospital, on the border of Mozambique and South Africa.

There, I met an MSF doctor, who told me about the organization. The idea of going into low-resource settings and helping to make an impact in the system appealed to me, and I wanted to experience medicine outside of South Africa. So I went on multiple missions with MSF — to Pakistan, Afghanistan, Libya, Syria, Haiti and Sierra Leone.

It was in Pakistan in 2011, on my first assignment, that I saw patients dying due to incorrect triaging. One day, I lost a patient. A young woman, 22 years old, came in with abdominal pain. She was incorrectly triaged, and she waited for eight hours. She had something called an ectopic pregnancy — a pregnancy outside the uterus — and she was bleeding internally. When I found her, she was barely alive, and we tried everything to resuscitate her. But she died — and it really affected me. She was a woman, she was sidelined, she was put in a corner — no one cared, no one did the triage properly. If she’d been triaged correctly, we would have realized she was pregnant, and we would have prioritized her.

From that day on, I became determined to sort out the triage problem. I was part of a team that implemented the South African Triage Scale in my emergency room, and it was the first time it had been used in an MSF hospital. It was the first time the South African Triage Scale was ever implemented in Southeast Asia.

Villagers from Hhohho, Swaziland, wait outside to get their vitals taken before seeing a physician or dentist. Photo: Air Force Staff Sgt. Lesley Waters

What is the South African Triage Scale?

It’s a paper-based system based on a composite score — including complaints and vital signs — and one of the only triage scales made for the developing world to evaluate both adults and children. It was developed in a small but busy hospital in Cape Town in a low socio-economic area in response to massive patient loads, understaffing and high death rates. It was introduced in 2008, and shown to be effective when implemented.

MSF had never had a standard triage system in place before this. We lobbied hard for change and standardization. They let us try it, and we did a study that showed a successful implementation. It was at that point that MSF realized how valuable it was, and they started implementing it in every emergency center around the world.

But this is not necessarily a one-size-fits-all solution. The South African Triage Scale (SATS), being relatively new, has been tested extensively in South Africa, but not yet rigorously tested outside of the country. I’m now working on my PhD, documenting the SATS’s validity and reliability in other sectors and countries. For the last two years, I’ve been collecting data on the SATS and how it’s been implemented globally. We proved that it works in Pakistan, and we proved that it works in certain African countries. But Afghanistan and Haiti are different. What are those differences, and how can we adapt the system for local circumstances? In Sierra Leone, for instance, there was a massive malaria population, which has lower hemoglobin levels. Because of that, the triage scale wouldn’t pick up certain patients, so we would have to adjust one or two discriminators after research so that the triage scale is more sensitive for these people. Small things like that make a massive difference in patient care.

Why create a mobile app, when it sounds like the paper-based system works very well to correct the possibility of human error?

Even though the SATS works, it still needs to be implemented correctly across a variety of situations, so we need to standardize the format to further avoid human error. Health care workers are trained to various degrees across different countries. One of the easiest ways to standardize things is through technology. When I came home from Pakistan, I discussed my experiences with my friend Yaseen Khan. Together we decided we had to tackle health system problems using technology — and that’s how we formed The Open Medicine Project (TOMPSA).

When you look at the way the nurses or health care workers make mistakes, it’s usually one of two areas: it’s either they don’t understand the discriminator — so the first symptom that the patient comes in with. The paper-based version of the SATS offers no additional information, whereas a mobile app can. They also make mistakes in calculation. In the SATS, the vital signs are all linked to a composite score, and each one is different. So say, for example, you have a heart rate of 98 beats per minute, that’s zero point. If you have a heart rate of 101, that’s one point. It’s easy to make mistakes, and a massive number of errors are happening in that scoring system alone. So digitizing systems offers more information as prompts for medical care depending on the score. Nurses were forgetting to do pregnancy tests, for example.

The app is essentially a digital checklist. Checklists make massive differences in both the airline aviation industry as well as in medicine. You see the same thing with the WHO surgical checklist. It saves lives.

Can you, say, take someone’s blood pressure and have the reading go directly into the app for analysis?

We would love to do that, and that’s where we’re going with this in the future, as more devices become more integrated. At the moment, entering such information has to be manually based because we can’t afford the technology in our public hospitals. But as we move forward, or as we adapt it for the private sector or other markets, those are definitely technologies that can be added.

The app assumes that everybody’s holding a smartphone of some kind. Is this a barrier for hospitals in developing countries?

The Open Medicine Project has institutionalized it — so we actually put an iPad in hospitals, in the triage area, where all the patients stream past. All the nurses use that iPad. We do have an application that’s freely available, for use on your personal phone. But that’s more for training purposes, for people to get used to the application. The one in hospitals links to a printer. At the moment it prints out a little sticker so that it can integrate into a paper-based system. the next step is to send information to the hospital computer system.

The problem is that within the developing world, you can’t have a fully digital system. Everybody thinks you can, but to be honest with you, you can’t. Everything’s still paper-based, everything’s still analog. You have to accommodate for that in your solution. That’s where your big problems come in with these massive solutions that cost millions of dollars — they’re beautiful and they work really well, but they don’t work for us. It’s Africa. And for many other African countries, the key is: how do you combine the two? How do you mix technology with something that can easily integrate into a system that has already been there for years?

So really all you need for this is an iPad, the app, and a printer. You don’t even need the internet.

Yes. And we want to open source the code soon, so that we can have a massive collaboration of people in hospitals excited to build onto the app to meet their own needs — including finding ways to integrate the app with bigger hospital systems. Our goal is to scale this phenomenally across Africa.

What about MSF? Will they also use the mobile app to replace the paper SATS?

Yes, we hope they will. They can take advantage of the open source aspect as well. As long as developers have a base to work from, they will come up with some really cool ideas. One of the requests that came through was, “Can we have animations on the triage application to show the nurse when the patient is hemorrhaging?” That’s a brilliant idea — you can almost unify triage systems so that nurses from different regions learn a standard system.

Another thing that can be added is emergency guidelines from each country. The app can then become a knowledge base in any hospital that has an iPad. All these ideas are out there. It’s now, “OK, let’s put it out there, let’s get it up — then let’s go wild.”

A look at TOMPSA’s Mobile Triage App. Photo: Makkia da Costa

Is the application already done?

It’s already done, and freely available on the Google Play store and for iPad on the App Store. But that’s a version without the printing function. We’re working on a mobile printing version where it can be made open source, and then we’ll see where to go from there.

You mentioned in your talk at TEDGlobal 2014 the possibility of using the app for epidemiology. Can you explain more?

We set out to do a simple task, but then we started realizing the value that we can actually get from this — the diagnostic capability. You can start improving diagnosis by analyzing simple metrics like heart rate and blood pressure that can be used to calculate a shock index — an idea that a fellow emergency doctor gave us.

We also started looking at helping hospitals be more resource-efficient by analyzing data generated by their triage color system — sort of a surrogate marker for how sick a patient is. So if a patient is red, we know they’re going to use more resources. If they’re green, they’re not so sick, and will not use as many. Now, for the first time, because we have found an electronic format, we can actually analyze resource use. On a Friday night, the hospital has seen ten or eight red patients; on a Wednesday night, you only see one. But the staffing is exactly the same. Shouldn’t they change something to maximize effectiveness?

Taking it a step further, if you monitor certain alerts coming from hospitals in a region, simple algorithms can alert you to, say, a lot of children under five having diarrhea. Is it seasonal variation that’s normal, or is there something else going on? And then you can start looking at almost real-time epidemiology, which has never been done before.

Don’t we already monitor diseases in real time?

Yes, but it is based on mortality reports. If you monitor live trends, you can be proactive rather than reactive, and respond in time, before people die. Is there a water contamination issue, or a food poisoning outbreak? To me, that’s the key to public health, to medicine in the developing world. For too long, we’ve been only reactive. Only after hundreds of people die, we say, “Oh, I think there’s a problem here. Maybe we should go look at it.”

Wouldn’t this be also useful for the developed world?

It could. This is the nice thing — the technology can be translated for a lot of different purposes for different countries. Obviously the triage algorithms will be different in different countries, because there are four major systems in the world. But that can easily be sorted.

So if the triage system in Canada works fine, for example, we’d base the app on that. They have digitized systems already, but I don’t think they’ve ever understood the link to epidemiology. A lot of systems are also fragmented in the developed world. Electronic medical records don’t talk to each other. But if we link up anonymized, secure data to a central place to monitor the health of a nation or a population, epidemiologists could really start understanding and interpreting the data.

Does this mean that currently, epidemiologists only look at numbers of deaths rather than numbers of cases of symptoms coming through?

They do try to look at symptoms. For example, they look at how many patients contract TB per year, how many patients are HIV positive. But they look at diagnoses, not symptoms. That’s not bad, because diagnosis is what you need. But there’s no reliable way of actually recording that information.

For example, with TB notifications in South Africa, you have to fill in a form. You don’t know if that form ever gets to the post office, or to the places that they’re supposed to be, so numbers are underreported. And there’s no verification numbers that come in.

If you digitize the information, and make sure everything is recorded, you can see from which hospital — from which nurse — this information was sent. It’s an amazing verification mechanism. Improving the ability to report means you have better data. Better data means you can make better decisions. Better decisions mean better patient care, more lives saved. Boom.

Mohammed Dalwai provides a medical consultation to one of the 800–1000 migrants and refugees living amongst boats on an abandoned military base on the outskirts of Tripoli. Photo: MSF

Do you anticipate privacy issues?

I think that the biggest privacy issue is about patient data, and it’s an issue that’s always highly considered in our whole process. How do we ensure patient security of their data, and make sure that no one is compromised? In a way, the diagnosis is the sensitive issue. You don’t want to know if someone’s HIV positive, for example. But then, how do you secure the data?

You take certain steps to make sure that the data is secure, you take steps that comply with all the regulations, and then you try and do the best for the most people. Obviously there are going to be hackers that can hack into anything. But if you comply to all the regulations and you make sure that you have strict security, I think it’s important to be able to do that. We must also be careful to balance these issues with the good of what this can achieve.

How far are you prepared to take this vision? Is this something that you want to follow through alone, or would you like it to be fully open source?

It was never just me from the beginning. My co-founder and friend has walked this path with me, with many people joining us along the way. At the end of the day, I would like to see this as one of the triage systems or solutions that we can use across many developing countries, and even, if needed, in the developed world. The idea, for me, is I want to make sure my patient never has to die again. That I will never again experience what happened in Pakistan.

I want to see this kind of system help with the improvement of triage across the developing world. Even if others don’t use our solution, as long as there is a system that works, one that’s been validated, scientifically proven — let’s do this for our patients. Emergency medicine is growing as a field, and more and more people are accessing the health care system through the emergency room. That’s our gateway to hospital, and that’s why we need to make sure the gateway is effective. Triage is a vital component.

]]>http://blog.ted.com/how-a-ted-fellows-mobile-triage-app-could-save-lives-around-the-world/feed/6IMG_4833mmechinitaMohammed Dalwai shares his idea for a Mobile Triage App at TEDGlobal 2014. Photo: Ryan Lash/TEDVillagers from Hhohho, Swaziland, wait outside to get their vitals taken before seeing a physician or dentist. Photo: Air Force Staff Sgt. Lesley WatersNurse at Khayelitsha hospital, Cape Town, using the Mobile Triage App. Photo: Gregor Rohig TOMPSA's Mobile Triage App. Photo: TOMPSAMohammed Dalwai provides a medical consultation to one of the 800–1000 migrants and refugees living amongst boats on an abandoned military base on the outskirts of Tripoli. Photo: MSFVideo: Parent by parent, rebuilding trust in vaccination in Pakistanhttp://blog.ted.com/a-short-film-from-a-ted-fellow-tackles-the-issue-of-vaccination-in-pakistan/
http://blog.ted.com/a-short-film-from-a-ted-fellow-tackles-the-issue-of-vaccination-in-pakistan/#commentsFri, 10 Oct 2014 12:30:00 +0000http://blog.ted.com/?p=92948[…]]]>

Pakistan is facing a polio crisis from unvaccinated children, because health workers are viewed with distrust — if not outright targeted by the Taliban. (Why? In 2013, it was revealed that the CIA ran a fake vaccination campaign as cover to hunt for Bin Laden.)

This moving short film is part of a campaign to help rebuild trust, parent by parent, in the health system and vaccinations. TED Fellow Bassam Tariq, a filmmaker (and a Halal butcher), produced the film as a public service announcement aimed at Pakistani migrant workers in the United Arab Emirates. The point: to encourage them to get their children back home vaccinated. The film is being shown in cinemas and migrant camps in the UAE, on airline flights between the UAE and Pakistan, and on Pakistani television.

He tells the Fellows blog about Pakistan’s polio crisis and how he approached the subject.

“Polio is an escalating health crisis in Pakistan because people are reluctant to vaccinate their kids. Their mistrust stems from the discovery that the CIA had been pretending to vaccinate while gathering swab samples to find out where bin Laden and other Taliban leaders were. Because of that, the Taliban is now killing health workers. After the success of These Birds Walk on the festival circuit, I was approached by the Gates Foundation and Image Nation, an Abu Dhabi film group, and commissioned to do a piece that would speak to Pakistani men working abroad, as well as within Pakistan, about polio.

“Pakistani migrants are predominantly men, and they are usually marginalized and spoken down to when it comes to media messaging. So for us, it was important to be authentic and empathetic, and be a voice from home, when speaking about something as serious and urgent as polio.”

]]>http://blog.ted.com/a-short-film-from-a-ted-fellow-tackles-the-issue-of-vaccination-in-pakistan/feed/2Screen-Shot-2014-10-08-at-11.52.29-PMmmechinitaEmbroidery for empowerment: A Q&A with Khalida Brohi that reveals much more of her incredible storyhttp://blog.ted.com/embroidery-for-empowerment-a-qa-with-khalida-brohi/
http://blog.ted.com/embroidery-for-empowerment-a-qa-with-khalida-brohi/#commentsFri, 10 Oct 2014 00:42:00 +0000http://blog.ted.com/?p=92850[…]]]>

Khalida Brohi grew up traveling between two very different parts of Pakistan: the bustling city of Karachi, where her parents moved so that she and her sisters could go to school, and a small village in Balochistan, where her family has its roots. Brohi got a modern education, and also developed a deep reverence for her tribal traditions. Those two threads often tangled — especially when it came to the treatment of women.

As a teenager, Brohi watched as, one by one, her childhood friends entered arranged marriages, sometimes against their will. When she was 16, she received word that a close friend had been murdered by her family in an “honor killing.” She set her mind on starting a movement to stop these practices. But as it gained momentum, it also spurred a backlash.

“We were challenging centuries-old customs in these communities. They stood up, saying we were spreading un-Islamic behavior,” she says. “We were standing against the core values of people, challenging their code of honor and hurting them deeply in the process.”

So Brohi did something outrageous: she apologized. She asked the communities for forgiveness — and then asked for her tribal leaders to support her in an effort to promote one of their prized traditions: embroidery. She got them on board with the idea of establishing a center in the village where women could get together and stitch embroidery. And while these women gathered to learn and work, in a rare moment without male supervision, Brohi and her team offered up information about their rights along with instruction in this ancient art. By creating these embroidery centers, called the Sughar Empowerment Society, Brohi has had more of an impact than she ever could have imagined.

Brohi just shared her story on the TEDGlobal 2014 stage. We spoke to her before she left for Brazil. Below, three key questions from that interview. Read the full Q&A on Ideas.TED.com.

You’ve said that Sughar is part embroidery and part empowerment. How do those fit together?

Inside the center, we actually teach three things. The first is enterprise development. The second is life skills, with education on women’s rights. And the third is traditional embroidery. We have chapters on all three. Local facilitators teach the women for six months.

We’ve also learned that we have to teach men as well as women. For men, we had to come up with something really amazing, because men weren’t very interested in our work. We came up with the idea of cricket tournaments. We started bringing in different cricket teams that were famous in the area, and inviting the men from the villages to watch the match. And we would have one of our team members do the announcing. Our team member was taught that — in the middle of the game, when everyone is very excited about what’s going to happen next — that’s the time to start talking about women’s rights. Since everyone wants to know what’s going to happen, they don’t want to move. A majority of the men sit there, watch the game, and listen to these messages that are very important for them to hear. We’ve seen that these messages are having a very slow impact on them. They go to the markets and they say, “Hey, did you hear that in Islam…”

The other thing we do for men is a monthly meeting. We ask men the question, “What have you done for your women this month?” It can be, “I gave her two pills for a headache.” And they are really proud to share this. Every month, even if it’s two men sharing things, we make it such a big deal. We clap for them and show what a hero they are. Every month, more men get inspired. When they tell that story in front of everyone, the whole village claps for them.

How did you learn embroidery?

As a child, I’d see all my aunties sit every day at 2 p.m. — after lunch was done and they had cleaned the house — and sing as they did embroidery. In my tribe, there are many, many songs and the women all sing to each other as they embroider. I would be playing, and my grandmother would pull me aside and make me sit down. She would tell me that no one would marry me if I didn’t do embroidery. As a 9-year-old, I had to learn all the patterns. She was thinking that I would get married at 11, and because I was soon to be a bride, I needed to know this.

An embroidery circle. Photo: Courtesy of Sughar Empowerment Center

In the villages, women are not allowed to speak a lot. They’re not allowed to laugh loudly, because it’s immodest. So I’ve always been really curious what people are thinking when they’re silent. When I was sitting with older women and they were silent, I realized that they were using these patterns. They would use extremely bright colors — yellow, orange and dark red. They’re not able to talk, but the embroidery is talking for them. They speak through something they’re creating. They would create something for their daughter’s dowry, and it was all like colors exploding from the dress.

When I grew up and Sughar came into shape, I realized that women want to talk. They want to share the stories that mean so much to them. Embroidery can do that for them.

What does Islam say about women’s rights?

That men and women should be equal. Our Prophet Muhammad, peace be upon him, said that they should be shoulder to shoulder, so it is very much emphasized that women should be equal to men.

There were many times inside the centers when women found out what their rights were — that when they’re sick, their husbands should take them to the hospital or that they should be allowed to go by themselves. The women would be very angry. They were like, “Oh my god, let me talk to him today.” We said, “We are not teaching this so that one gender should have more freedom than the other. We are doing this so that both of you are balanced.”

]]>http://blog.ted.com/embroidery-for-empowerment-a-qa-with-khalida-brohi/feed/3TG14_100914_DD5B5188_1920katetedKhalida Brohi speaks at TEDGlobal 2014. Photo: James Duncan Davidson/TEDAn embroidery circle. Photo: Courtesy of Sughar Empowerment CenterNot a bug splat: This massive portrait is a message to drone operatorshttp://blog.ted.com/an-inside-out-portrait-that-delivers-a-message-to-drone-operators/
http://blog.ted.com/an-inside-out-portrait-that-delivers-a-message-to-drone-operators/#commentsMon, 07 Apr 2014 17:59:52 +0000http://blog.ted.com/?p=89252[…]]]>This portrait of a girl tells a story larger than the massive piece of vinyl it is printed on. Unfurled in the Khyber Pakhtunkhwa region of Pakistan, “#NotABugSplat” was created by a collection of artists and activists, using TED Prize winner JR’s Inside Out campaign, to send a message to drone operators, who reportedly call their kills “bug splats” because they appear small and grainy on screen. The idea is to “create empathy and introspection amongst drone operators,” explains the project website.

Below, an image JR posted about this Inside Out project via Instagram:

Growing up in the UK and coming of age in Pakistan, TEDIndia Fellow Asher Hasan observed a vast discrepancy: those with and without access to basic healthcare, and the devastating social consequences of this disparity. He tells TED Blog the story of how he witnessed a single health disaster ruin the hopes of his childhood friends, and how this compelled him to attempt to transform a broken healthcare system with his Pakistan-based health micro-insurance company, Naya Jeevan, which offers not only quality, affordable healthcare to the urban poor, but also the financial and social inclusion the rest of us take for granted.

What does your organization do, and why?

The name Naya Jeevan traces its roots from Sanskrit, and means “new life” in modern Hindi and Urdu. We are committed to bringing low-income families in the emerging world out of poverty by providing them with affordable access to quality healthcare, financial inclusion and socio-economic opportunity. This is important because in many developing countries, catastrophic medical events trigger financial shocks that can decimate low-income families, especially as they have no public support system or safety net.

We collaborate with large, multinational corporations, and cascade our health plan up and down their value chains, essentially targeting low-income businesses and workers — mainly informal workers, domestic workers, factory workers and so on — who are either on the supply side or on the distribution/retail side. We encourage corporate executives and managers to enroll their informal domestic employees. So, for example, you could be a small-hold farmer supplying milk to a dairy company. You could be a retailer — or a micro-retailer, in some rural village — who happens to be selling a basket of products that includes products by Unilever, P&G, and so on.

For example, Unilever, which is re-launching our domestic worker plan this year, encourages its officers and managers to enroll their domestic staff — their drivers, maids and those workers’ families — in our healthcare program. The premiums are deducted from the payroll of the Unilever manager or executive. Or a corporation might directly finance the healthcare of micro-retailers who are selling their products.

The beneficiary can make co-payments, typically by mobile phone, using mobile financial services now widely available in South Asia. Enrollment in a mobile bank account will soon be part of the health plan we offer, because the people we typically serve are also unbanked. This way, they get the additional benefit of building up a financial transactional history that serves as a de facto credit report for them.

Naya Jeevan addresses socio-economic empowerment as well, tackling the informal system of what I call socio-economic apartheid in many developing countries, where there’s a rich, elitist class, and then there’s the other 90% that serves them. The rich get so used to this social dynamic that they almost start treating those who work for them like subhumans. I’ve seen many instances where even friends and family, in certain instances, have abused their domestic staff — yelled at them, beaten them, and so on. It’s absolutely disgusting, and it has to stop. Because this master-servant mindset is still pervasive, employee benefits of any type have never before been extended to these informal employees. Prior to Naya Jeevan, nobody ever considered the possibility of giving health insurance to their maid, or to their driver, or to their driver’s child, for example.

There’s a personal hook to this story…

There’s very much a personal hook to the story. My father was born in India, but some of his family members were raised in Pakistan. As a young man, he went to the UK, so I was born and raised there until I was 11, when my dad passed away from cancer. My mom, who was also born in India but raised in Pakistan, brought us back to Karachi, and I finished my schooling there.

When I first travelled to Pakistan, I was really shocked to see the tremendous disparity between rich and poor — between the elites who had unlimited access to resources and opportunity, and everybody else, who didn’t. I was especially shocked about the lack of access to healthcare in comparison to the UK, where everyone, regardless of income, has access to a national health insurance system, and where, relatively speaking, people of varying incomes have a fairly comparable quality of life.

I had direct exposure to this disparity between rich and poor. My mother had a maid with six kids, who were all within my age range, between 8 and 14. I was 11 when I first moved to Pakistan, and grew very close to these kids. Essentially, they were like my siblings. These kids were brilliant, dynamic — and I’m convinced that if they had the opportunity or had they been born in a different country, they could have become leaders of our country. They were far more intelligent than I was, that was for sure. And even though their parents — the maid and her husband, who was a mechanic — were very committed to educating them, there was a glass ceiling, a predefined trajectory that their lives seemed to be taking.

The year I left for the US for college, their father had a stroke. He’d had many, many years of uncontrolled blood pressure. Typically, in the lifestyle of low-income laborers, there’s no concept of preventive health care. It’s very much crisis management. He was taken to a public hospital, not diagnosed in time, not treated in time, and ended up paralyzed and completely incapacitated.

This had a devastating effect on the family. The kids’ mother, a very proud lady, did not want to depend indefinitely on charity, so she made the rather fateful decision to pull all six kids out of school and place them in different child labor situations. Two ended up in houses working as maids, two ended up on the street selling candy, two ended up working in apprenticeships. All six of them ended up being sexually, physically and psychologically abused.

When I returned to Pakistan during my sophomore year for a visit, I was really disturbed to see the profound impact their father’s incapacitation had on their lives. These once dynamic, bubbly kids who were full of life were completely jaded and disillusioned. It was almost like their lives had been sucked out of them and they had simply given up. Rabia, who is three years older than me, said, “You know, I’m the daughter of a maid and I’m destined to be a maid. This is my ‘kismet’ (fate). We can’t expect to be treated like royalty, or to come out of poverty.” Her father’s stroke was the first trigger event that put me on the path of doing what I do.

A child taking care of her baby brother while her mother, a domestic maid, is busy working. This is a major issue with informal workers, who don’t have access to day-care — leaving them exposed to a variety of social hazards. Photo: Naya Jeevan

What happened next?

I went to medical school in the US, spent a couple of years at Harvard Medical School and Mass General Hospital tinkering around in the research labs, and then moved on to Beth Israel for surgery residency. I then transitioned into the pharma-biotech industry, which ultimately took me to San Diego, land of the cushy lifestyle, during which time I also completed an MBA from NYU. By the summer of 2007, I had acquired scientific acumen and learned some business skills. Materially and intellectually, I guess I was quite enriched, but I felt spiritually bankrupt. I think my spirit was very restless at that time and craved something more meaningful. I got another jolt in 2005, when my mother, a diabetic for many years, also ended up having a massive stroke. She was taken to one of the best hospitals — in fact, she only lived about 10 minutes away from one of the best hospitals in the country — but she died on the way there.

My mother’s death was another powerful trigger event for me. It was like someone drilling a message into my brain: “Wake up, stupid! You have lived and witnessed socio-economic apartheid, you have accumulated all this technical expertise, you understand the healthcare system, you understand the Desi culture, you speak the language, so what are you doing about changing the system?” I had to look deep inside myself in search of an answer to that question.

I started thinking seriously about what I needed to do to change the direction of my self-centered life and to do something to tackle this issue head-on. Ultimately, if we want to get both people and developing countries out of vicious cycles of poverty and aid dependency, we need to do everything we can to create the scaffolding that will enable them to build their own way out. Given my background, I thought, “Okay, I need to come up with a healthcare model that’s sustainable, scalable, replicable, and will help to transform or catalyze the transformation of the healthcare system in Pakistan and subsequently in other emerging nations.”

I left the biotech industry, took a quantum leap of faith and and plunged full time into tackling this issue. I took a bunch of graduate students with me to Pakistan and India, and we did a fairly thorough, three-month landscape analysis of the health systems there to understand the nature of the beast. We looked at the health care systems, the stakeholders, the role of the private sector, the role of the corporations, the role of the public sector, public health systems. It was a fairly rigorous assessment of what the status quo was, what the unmet needs were. We interviewed a lot of our potential customers — low-income beneficiaries — to better understand their needs.

What did you find?

We realized, during that assessment, that there was actually a fairly robust private health insurance system in place in both countries, but only the corporate elite had access to it. So if you happened to be working for Coca-Cola, or for P&G, or for Unilever, then you were included in the system — otherwise you were excluded from it. Most people in India and Pakistan were not even aware that such a system existed. It works much like it does in the US, where you have access to a network of hospitals. You show your membership or health plan card, and you get treated. The same system was growing and developing in both India and in Pakistan. So we thought, rather than reinventing the wheel, why not just leverage this system but enhance it by adding features that would address the needs of the marginalized?

We started meeting with various health insurance companies and negotiating large group health plans. If we were to enroll 500,000 lives, what is the best price they could give us? Along the way, we realized that we needed to wrap these health insurance plans with services that also met the immediate, tangible needs of the marginalized.

What are some of those needs?

Health insurance in many developing countries tends to be catastrophic in nature — mostly hospital based. Healthcare in the primary, or outpatient setting, is typically unregulated. It’s very difficult for insurance companies to monitor or verify appropriate treatment. So they choose to mitigate their risk by just focusing on inpatient hospital-based care, which is easier to monitor and regulate. Yet the marginalized actually need greater access to primary care — primarily because of the higher-risk, more polluted environments they live and work in. The challenge for us was how to address these needs in a scalable way?

We started providing our members with 24-7 mobile phone access to family doctors, who would also have examined each patient that would help establish a baseline heath assesment to identify latent or hidden disease. After that assessment, we’d basically provide large employer groups with a group risk profile of their worker population, and recommend and deliver customized interventions, interactive preventive health workshops, or health education seminars. If we notice that there’s a group of women working in a factory who perhaps don’t know enough about breast cancer prevention, we’d conduct a workshop on breast cancer screening and self-examination given by one of our doctors.

We also recognized that a lot of poor people feel really intimidated when they walk into a gleaming private hospital with lots of sophisticated medical equipment. It’s unnerving and disorienting for them. Historically, they’ve also been discriminated against in those environments. In order to make them feel more comfortable, our family doctors also serve as liaisons, navigators and patient advocates. They will speak in advance to the hospital’s treating physician, and say, “I’m sending my patient to you; please make sure they get good, quality care.”

If we receive customer complaints or reports of substandard treatment or any kind of social discrimination, the care provider and hospital don’t get reimbursed for that care. This financial penalty creates a kind of a check and balance to make sure that our members don’t face discrimination or get pushed down the list to make way for higher-income patients. Social prejudice was a major concern when we first started enrolling our low-income members, so this is something we remain vigilant about.

Safiya, a resident of an urban slum in Karachi. Photo: Naya Jeevan

Given that there has been no culture in Pakistan around helping the underserved, how did you suddenly bridge that gap?

That’s a very good question, and this is where I think generation X and Y are playing a huge, catalytic role. What we have seen is that the early adopters of our health plan for the marginalized have been younger, more globally connected entrepreneurs and corporate business people, who tend to be in their 20s and 30s, and understand the benefits of this. I have witnessed more empathy from them than generations that preceded them. The younger generations realize that it’s not only unfair, but that there’s just something intrinsically and morally wrong about this social injustice.

So the millennials and Ys have kept us in business. The good news is that the demographics are shifting rapidly in that direction. Two-thirds of Pakistan is now below the age of 25, so the demographics are increasingly in our favor. We’re optimistic that we’re close to the “tipping point” that Malcolm Gladwell refers to, and on the verge of really taking off in a big way. But it is absolutely true that health insurance for low-income workers remains a big paradigm shift for many employers — both informal employers and formal employers, as well as employers who contract in services. A lot of people circumvent the law — which they also do in the US, by the way — by hiring a contract-based workforce. If you’re a contractee, or you’re part-time, you’re not entitled to benefits. It’s exactly the same in the US.

But in Pakistan, because the cost of that benefit is so cheap (only $2 per person per month), we have been able to convince a lot of employers to enroll their part-time or contractual staff into these plans as well. A lot of corporations are doing that it. Two dollars per person per month is a drop in the ocean for many of these large companies.

How does this service directly benefit corporations?

For our corporate clients, insuring employees has proven very valuable, because there have been a multitude of cases we have screened and isolated where client-facing employees could have potentially passed on airborne infectious disease to clients, which would have been a PR fiasco. One particular company came to us as soon as one of their field representatives, who was a contract employee died in a road accident. They suddenly realized after this tragedy that they were exposing themselves to a lot of reputational risk, and that they needed to protect all of their field workers.

So sometimes it’s reactionary, but sometimes it’s also proactive. The ultimate form of asset protection is human asset protection — that’s what health insurance is. I think some companies are beginning to understand that it’s no longer sustainable for them to maximize profits in the short term at the expense of long-term externalities.

How many people do you now serve, and what is in store for future?

Currently, about 250,000 urban slum dwellers have access to our primary care plan, and an additional 68,000 members have been enrolled in our health insurance plan across 90 companies over the past four years. To achieve sustainability, we need to get to 150,000 insured lives. Those of us who are more optimistic have projected for Q2 of 2015; those who are more conservative have projected for Q2 2016. So, knock on wood — let’s see if we can make it sooner rather than later! It’s pretty ambitious, but, you know, we’re a fairly ambitious bunch of people.

]]>http://blog.ted.com/working-for-the-health-of-the-many-how-asher-hasan-is-bringing-insurance-coverage-to-pakistans-low-income-workers/feed/7Blog_FF_AsherHasan_CleanmmechinitaBlog_FF_AsherHasanA child taking care of her baby brother while her mother, a domestic maid, is busy working. This is a major issues with informal workers, who don't have access to day-care -- leaving them exposed to a variety of social hazards. Photo: Naya Jeevan Safiya, a resident of an urban slum in Karachi. Photo: Naya JeevanMy City: Khurram Siddiqi on how not to get lost in Lahore, Pakistanhttp://ideas.ted.com/my-city-khurram-siddiqi-on-how-not-to-get-lost-in-lahore-pakistan/
http://ideas.ted.com/my-city-khurram-siddiqi-on-how-not-to-get-lost-in-lahore-pakistan/#commentsThu, 17 Oct 2013 16:45:31 +0000http://blog.ted.com/?p=82278[…]]]>

“In Lahore, you don’t get lost: you start off lost,” explains Khurram Siddiqi. “It’s a condition, not a situation.”

Siddiqi, and his friends Asim Fayaz and Omer Sheikh, decided to collaborate on a proposal to install and maintain road signs in the city after it took several phone calls and half an hour for Fayaz to navigate the 5-minute drive from a main road to Siddiqi’s house for a TEDx planning meeting back in 2010. With $10,000 in seed funding from the TED City 2.0 Award, the trio chose the streets of Allama Iqbal Town, a densely populated area developed in the late 1970s in southwestern Lahore, as their testing ground.

The neighborhood is named after the national poet of Pakistan, and, fittingly, words decorate almost every surface: store awnings stacked several stories high, political banners strung across the street, billboards for the latest Porsche, hand-written flyers stapled an inch deep onto telephone poles, multi-colored trucks emblazoned with verses from the Koran, and old Dawn puri cartons filled with yellowing Enid Blyton paperbacks.

The only thing missing are the street signs. On Lahore’s main highways, large blue placards give clear directions in both Urdu and English. In the chaotic, dusty alleyways on either side, however, the chances are good that eighty percent of the men yelling into their mobile phones are actually asking for directions.

This chaos is the opposite of Siddiqi’s daily life: just four miles away, he teaches undergraduate electrical engineering and enjoys a spacious office overlooking the lawns of the main quad at the National University of Computer and Emerging Sciences. What’s more, if it weren’t for all the foliage in between, he could see his house from his office window. “I can go home for lunch and see my baby daughter!” Siddiqi tells me, in the tone of a man who can hardly believe how lucky he is. (Curiously, he also met his wife at TEDx, where she was a volunteer, which makes their baby a close competitor to the street sign project as the most exciting outcome of TEDxLahore).

Fayaz and Siddiqi continue to meet at each other’s houses to work on their signage project, rather than at a Starbucks, as Siddiqi would have done during his grad school years at the University of Southern California in Los Angeles. “You have to get dressed up to go to a coffee shop in Lahore,” Siddiqi explains, mournfully. Rather than serving as informal offices and homework stations, in Lahore, branches of Gloria Jean’s (an Australian coffee chain popular across the subcontinent) are a destination, filled with chic twenty-somethings. Sometimes, entire wedding parties enjoy a post-reception chai latte to a soundtrack of Western pop.

“At my house, at his house, and at my office, we designed and redesigned and redesigned again,” says Siddiqi of the signage project. “We hunted down the longest road name in Allama Iqbal Town (Molana Hasrat Mohani Road, after another poet), we tried different fonts, and we struggled for quite a while with the fact that the vertical height of Urdu letters is larger than that of English.” Finally, the team arrived at a bright yellow design, cut and glued a posterboard prototype on Fayaz’s living room floor, and stuck it on an electricity pylon at the corner of two quiet, concrete-grey residential blocks on the neighborhood’s southern edge. It wasn’t a success. “It looked really big when it was coming out of the printer, and it was hard to read out on the street,” Siddiqi admitted. “But that’s cool. I’m a fan of making dumb mistakes in the prototyping phase.”

To date, Fayaz and Siddiqi have spent hours balancing different sign options on top of onion sacks and car bonnets in the streets of Allama Iqbal Town to get feedback from taxi-drivers, vegetable vendors and residents alike. The team also met with the head of a sign company who was visiting from Islamabad. “We met in the lobby of one of Lahore’s fanciest hotels–all marble and crystal and a guy playing the piano. I can’t stand those places, but he was staying there,” recalls Siddiqi. “He was really helpful. He shared a lot of signage trade secrets and saved us hours of research.”

Although Lahoris rely on landmark-based navigation, for Siddiqi, the essence of a city is to be found in its soundscape, rather than a particular place or view. [To read about someone who thinks similarly, see this profile of Jason Sweeney and his home city of Adelaide, Australia.] “When I first got back to Lahore from the US, it was the sound of the city that hit me right away,” he tells me. There’s a saying in Pakistan, he explains: a car needs a horn more than it even needs an engine. To the incessant honking add the high-pitched whine of two-stroke moped and auto-rickshaw engines, the hypnotic chanting of street vendors advertising their wares, and the percussive beats of a dholki player or two, and you could only be in Lahore. For Siddiqi, who DJs a show on a local radio station, those sounds are an endless source of creative inspiration: for his sets, he often mixes field recordings from the local bazaar or his favorite ice cream shop in with the latest in electronic music.

That said, he admits that it was a recent drive through the oldest part of Lahore — the original walled city of the Mughals — to pick up his sister at her college that made him fall in love with the city all over again. The traffic is terrible in that part of town, and Siddiqi’s work, family and friends typically keep him in the newer, leafier parts of the city. “But it was so refreshing — it’s so dense and there were so many people and not a single tree, and I thought: this is Lahore.”

Although he was born in the city, Siddiqi spent large parts of his childhood in Saudi Arabia, where his father taught architecture in Jeddah and Dahran, and then he lived in the United States for nearly a decade, studying electrical engineering at Purdue and USC, and then working in Silicon Valley. His move back to Lahore in 2009 was inspired in part by the desire to spend more time with his family, but also drew on a related urge to reconnect with his roots, by a need to “uncover and share the city’s beauty, despite all the troubles it has gone through recently.”

That perspective — the critical distance of a returnee combined with the romantic filter of a nostalgic booster — has shaped Siddiqi’s ongoing and tumultuous affair with this equally dynamic, frustrating, magical and chaotic city.

Meanwhile, the team’s signage adventures continue. After negotiating layers of bureaucracy to secure a meeting with Lahore’s mayor in the city’s Raj-era government offices, Siddiqi and Fayaz have been told they have to bring their prototype street sign back on a pole in order to get approval. “If that’s what it takes,” Siddiqi says, “then fine, we’ll go back with a pole! We’re not urban planners or graphic designers, so we’re figuring out everything from scratch, but we’re getting there. The thing is, quality of life doesn’t care about your educational background. It cares that you get stuff done.”

These were the words spoken by 16-year-old Malala Yousafzai, above, the Pakistani schoolgirl who was shot in the head by a Taliban gunman in 2012 for advocating for girls’ education, at the UN Conference in New York on Friday. Wearing the late Benazir Bhutto’s shawl, Yousafzai spoke about education as a way to fight extremism. “The extremists are afraid of books and pens,” she said in her speech. “The power of education frightens them.”

In honor of Malala Day, “the day of every woman, every boy and every girl who [has] raised their voice for their rights,” we invite you to watch this playlist of talks all about the importance of educating women.

Yousafzai says that “the pen is mightier than the sword” but for an alternate perspective, watch this shocking presentation from filmmaker Sharmeen Obaid-Chinoy. In this talk from TED2010, she takes us inside a Taliban school and addresses the big question of how children are being convinced to become suicide bombers.

The TEDxBahrialUKarachi show went on, despite a bombing in the city the day of the event. Why? To give hope. Photo: TEDxBahrialUKarachi

The city of Karachi, Pakistan, was on lockdown after bomb blasts claimed 57 lives in the midst of a tumultuous election. And on the day of TEDxBahriaUKarachi, yet another bomb shocked the area. Still, organizers Furqan Hussein and Sana Nasir boldly tread onward toward putting on a memorable event. “‘Ideas for Survival,’ our theme, sowed the idea of surviving in situations when there’s [little] or no hope,” Nasir tells the TEDx Blog in an interview. “The one thing we wanted our audience to take back [with them] was hope.”

These are the lengths some TEDx organizers go to in order to put on great events — dozens of which are held across the world every week. From these events, the TEDx team chooses four favorite talks each week,highlighting just a few of the enlightening speakers from the TEDx community and its diverse constellation of ideas. Below, listen to this week’s talks – on topics ranging from the data revolution to how we perceive pain.

Democracy’s data revolution: Simon Jackman at TEDxSydney
At TEDxSydney, Stanford researcher Simon Jackman demonstrates some of the ways in which an increased availability of data gives us a more accurate picture of electoral trends, the political zeitgeist, and the serious implications this has on the shape of public conversation. (Filmed at TEDxSydney.)

African thumb piano jam: Hiroyuki at TEDxTokyo
At TEDxTokyo, Japanese artist Hiroyuki plays a remarkable musical performance on the kalimba — also known as the thumb piano. A handheld plucking instrument still relatively obscure in Western music, the kalimba is an ancient part of the heritage of several cultures in sub-Saharan Africa. (Filmed at TEDxTokyo.)

“Everything that I have learnt and achieved is a direct result of having a close connection to the online realm,” says Riaz. “YouTube [could] be the reason I became a TED Fellow. I would have never had a chance to speak on the TED stage or perform with Preston Reed — the man whose videos I used to watch on YouTube when I first picked up the guitar — if I didn’t have access to YouTube.”

Usman and friends have created a Facebook page called YouTube Aloud to gather information and fight the ban.

In September 2012, YouTube was banned in Pakistan during the furor over the film Innocence of Muslims, which many believed to be insulting to the prophet Mohammed. In early January, Pakistan’s government suggested it would lift the ban after installing filters, but the opening lasted about three hours before being shut again.

Riaz’s message: YouTube is too valuable for learning to be closed over one video. As he puts it in the Express Tribune: “Does it make sense to burn down an entire library just because you don’t agree with the contents of one of its books?”